13 Reactions to the Hobby Lobby Case That Are Completely Misinformed

On Monday, the Supreme Court issued a decision in Burwell v. Hobby Lobby, holding that the religious beliefs of owners of closely held companies can dictate what kinds of federal benefits employees might be entitled to. Hobby Lobby specifically dealt with the contraception mandate in the Affordable Care Act (ACA), and while the majority opinion, written by Justice Samuel Alito, indicated the decision only extended to that mandate, Justice Ruth Bader Ginsburg's dissent suggested it might reach much further.

Hobby Lobby, a for-profit chain of craft stores, claimed the ACA violated its rights under the Religious Freedom Restoration Act by requiring employee health plans to include contraception, including four methods the Hobby Lobby owners believe are immoral: Plan B, Ella, and two intrauterine devices (IUDs). The court agreed, and in a 5–4 opinion with all three female justices dissenting, held for the first time that for-profit corporations are entities that can have religious beliefs, and that Hobby Lobby's religious freedom was violated even by a generally applicable law.

In the wake of the decision, misinformation about the case has proliferated. While there's still a lot we don't know — how broadly the ruling will be applied to religious beliefs about medical care other than contraception, how Congress and the administration will tweak the law to make sure it falls within these new, still-nebulous boundaries — if social media commentary and even some of the news coverage of the case is any indication, many of the facts we do know are being misunderstood or intentionally manipulated. Here, we clear up a few of them.

1. Hobby Lobby objected to only four forms of birth control; they still provide 16 other options for employees, so what's the problem?

While Hobby Lobby the company did object to only four forms of birth control, Hobby Lobby the case is about the contraception mandate as a whole, and its holding applies to any closely held company. There are some 50 cases brought by for-profit companies on this same issue still pending (and many more brought by other organizations), and many of the owners of those companies object to birth control altogether. Under this ruling, employers of certain companies can decide that their employees won't have contraception coverage in their health plans at all — and that applies to any form of birth control an employer believes is immoral, not just the four contraceptive methods Hobby Lobby didn't want covered.

On top of that, not all methods of contraception work equally well for every woman, which is why birth control methods should be determined by a woman and her doctor, not a woman and her boss.

"Methods of contraception differ dramatically in their effectiveness," Adam Sonfield, senior public policy associate at the Guttmacher Institute, a sexual and reproductive health research organization, told Cosmopolitan.com. "Women's contraceptive needs and choices are influenced by concerns about side effects and drug interactions, how frequently they expect to have sex, their perceived risk of sexually transmitted infections, and a host of other factors. Women who are not completely satisfied with their choice of a method are particularly likely to use it inconsistently or incorrectly, or to experience gaps in use. For these reasons, women need access to not just any method of contraception, but to the one most suitable for their individual needs and circumstances. The fact that half of U.S. pregnancies are unplanned demonstrates that effective contraceptive use is a significant challenge for many women over their lifetime."

Even allowing employee insurance plans to not cover the four methods targeted by Hobby Lobby seriously restricts women's options.

"Women with increased cardiovascular risk, for instance, may need to use a copper IUD or other non-hormonal method to avoid the cardiovascular side effects of hormonal contraception," Leila Abolfazli, senior counsel with the Health and Reproductive Rights Program at the National Women's Law Center, told Cosmopolitan.com. And emergency contraception, she said, "fills a unique and critical need. It is a woman's last chance to prevent pregnancy after sexual assault, birth control failure, or unprotected sex."

2. Plan B, Ella, and IUDs are abortifacients.

Plan B and Ella are both forms of emergency contraception and are proven to prevent unintended pregnancy. They do not cause abortions. The medical definition of pregnancy is when a fertilized egg implants into the uterus (more than half of all fertilized eggs naturally flush out the body, never resulting in pregnancy). Once an egg implants, Plan B and Ella cannot dislodge it or end a pregnancy.

This gets into some sticky territory, because the position taken by Hobby Lobby and many people who oppose emergency contraception is that life begins at fertilization, not implantation, and Plan B and Ella may interfere with implantation of a fertilized egg. Even if we accept that definition of pregnancy and abortion — and credible medical organizations and providers do not — there is no evidence that emergency contraception prevents implantation of a fertilized egg. Instead, it primarily works the way standard birth control does: By inhibiting ovulation and thickening cervical mucus so sperm can't pass through. Fifth-grade sex ed was a long time ago, so a quick refresher: Pregnancy doesn't happen immediately after ejaculation. It takes some time for the sperm to swim up into the fallopian tubes, and an egg has to be released to meet the sperm. Sperm can live in the female body for up to five days, and an unfertilized egg can sit in the tube for several days as well. That's why emergency contraception works even a day or two after sex. Even after the sperm have been released, it can make it harder for them to get past the cervix, and then it can prevent an egg from being available for fertilization.

"Emergency contraception is not an abortion pill," Cecile Richards, president of Planned Parenthood Federation of America, told Cosmopolitan.com. "In fact, every major medical institution, including the Food and Drug Administration, states that Plan B One-Step and other types of emergency contraception are forms of birth control, and they cannot induce an abortion. Emergency contraception, effectively, is a high dose of the birth control pill that works by postponing ovulation, which prevents sperm from coming in contact with and fertilizing an egg."

As for IUDs, the copper ones work essentially by killing off sperm before they reach the egg, and according to the latest, most reliable research, neither copper nor other IUDs affect implantation of a fertilized egg. Now, copper IUDs can prevent a fertilized egg from implanting if they're inserted up to five days after unprotected sex, but the number of women who actually use IUD insertion as a form of emergency contraception is slim to none, given that the cost of the device and insertion can reach $1,000 and requires a doctor's visit (which is exactly why it's so important that IUDs be covered by insurance).

3. If you want to play, you have to pay.

This argument seems to apply only to women. Men get to "play" for free all the time. Nearly all women — 99 percent — will use some form of contraception in their lifetime and will spend years trying to prevent pregnancy. Sex is an incredibly common, thoroughly normal activity that human beings engage in for a variety of reasons, including to make a baby, but mostly for recreation. Insurance companies recognize the importance of recreational sexual activity in covering medications such as Viagra. Women should not have to "pay" — by which detractors seem to mean in both the "fund" sense and the "see consequences" sense — for basic medical care when they have health insurance to cover exactly that.

4. Why should a company pay for your birth control?

"Having your insurance plan cover birth control is not the same as getting free birth control," Julianna Gonen, director of government relations at the Center for Reproductive Rights, told Cosmopolitan.com. "As an employee, you earn those benefits just like you earn your paycheck. And just like your boss has no business telling you how you can use your paycheck, he or she shouldn't be able to pick and choose which services, medications, or procedures are covered in your health insurance benefits."

This case wasn't about a requirement that your employer hand out birth control pills. It was about requiring employee health plans — which you as an employee also pay for with your premiums, and which come as part of your employment package along with your salary — to cover contraception, one of the most commonly prescribed medications in the United States. Few would argue that a health plan covering asthma treatment means that "your company is paying for your inhaler." Similarly, a company health plan covering contraception doesn't mean your employer pays for your pills.

5. Birth control is only $10.

"Highly effective methods, such as IUDs, implants, and sterilization, are ultimately cost-effective, but can entail hundreds of dollars or more in up-front costs," Sonfield said. "Even for the pill, uninsured women on average pay $370 for a full year's supply; that is the equivalent of 51 hours of work for someone making the federal minimum wage of $7.25. So, it is no surprise that one-third of women would switch methods if they did not have to worry about cost."

As Justice Ruth Bader Ginsburg said in her Hobby Lobby dissent, "the cost of an IUD is nearly equivalent to a month's full-time pay for workers earning the minimum wage." Birth control pills are cheaper but can still run you $50 a month — that's a full day's pay for a minimum-wage worker, who may be choosing between contraception and groceries. Birth control pills also have to be taken daily and are all hormone-based, which isn't an option for many women (IUDs are highly effective and long-acting, and the copper version is hormone-free). Without insurance, emergency contraception costs $45, and many pharmacists refuse to give it to teenagers, even though those teenagers are legally within their rights to get it. And while $10 or $20 or even $50 a month may not sound like a lot, the average American woman spends three decades trying to prevent pregnancy and only about five years trying to become pregnant, actually pregnant, or postpartum. That means a woman paying $50 a month for her pills spends a good $18,000 avoiding pregnancy. To defray much of those costs, the ACA has made birth control much more affordable than it was just a few years ago, but those efforts have been partly stymied by this decision. Try Mother Jones's handy contraception calculator to see how much you would spend without the ACA and the contraception mandate.

6. This is a very narrow decision.

"Tell that to the American public who thought women's access to birth control was settled almost 50 years ago," Abolfazli said. "And tell that to the opponents who we expect to use this decision to push other discriminatory measures."

There are a whole lot of cases still pending where employers do not want to cover contraception. And this ruling may apply beyond closely held corporations to all companies. There's also the outstanding question of how this ruling will impact groups often not covered (or not covered comprehensively enough) by anti-discrimination laws, including LGBT people and women in contexts outside of the contraception mandate. Can companies refuse to cover HIV medications for gay employees or hormone replacement therapy for transgender employees?

"With this decision, the Court has given bosses the power to dictate how their employees can and cannot use their health insurance — opening the door for even further intrusion into other private decisions based on whatever personal beliefs their employers happen to hold," Gonen said. "And 'closely held' is not the same as small; there are many very large companies that are closely held, meaning this decision could affect thousands or millions more women."

7. This is about the First Amendment and Americans' constitutional rights.

Hobby Lobby was decided under the Religious Freedom Restoration Act (RFRA), not the First Amendment, making it a statutory claim and not a constitutional one. The RFRA was passed by a unanimous House and a nearly unanimous Senate in 1993 in response to the Employment Division v. Smith Supreme Court decision that many Americans — including, notably, many Democrats and President Clinton, who signed the bill — thought was outrageous: The Court held that the state could refuse to pay unemployment benefits to Native Americans who ingested peyote, a drug taken as part of religious rituals. The Court's reasoning was that the prohibition against peyote use was a neutral, generally applicable law that did not prohibit the free exercise of religion, and therefore did not violate the First Amendment. The RFRA raised the bar, so that Congress could not pass laws that substantially burdened the free exercise of religion, even if those laws are generally applicable. However, a law may burden religious exercise if it furthers a compelling government interest and is the least restrictive means of furthering that interest. That's the statute under which the Hobby Lobby case was decided, separate from First Amendment case law.

8. Birth control isn't medicine.

Birth control is prescribed by a doctor according to a patient's needs. The nonpartisan National Institute of Medicine qualifies it as preventative care. And while pregnancy is not a disease, it is a life- or health-threatening condition for many women. Before the advent of birth control, women died of pregnancy-related causes much more often than they do today. Research suggests that modern maternal mortality rates would be as much as eight times higher without contraception, and hundreds of thousands of women around the world see their lives saved and health preserved every year because of contraception access. That is vital medical care.

It's also worth mentioning that pregnancy is no cakewalk. It takes a physical, psychological, and financial toll — much of which is worth the sacrifice when you want a baby. But preventing a condition that by definition radically changes your body and often compromises your health is indeed medicine (even if pregnancy can also be beautiful and wanted and joyful).

"The facts are clear: 99 percent of women will rely on contraception in their lives to avoid unintended pregnancy and plan their families and future," Gonen said. "This represents an immense benefit not only to millions of women and their families, but to our society as a whole. Planned pregnancies are far healthier than those that are unplanned."

9. Employers will still have to cover contraception used for medical reasons.

First, Gonen says, "Using contraception to prevent an unintended pregnancy is a medical reason, as it relates directly to a woman's own health and the well-being of her family. Bosses have no business deciding which uses of essential preventive medical care are OK and which are not."

But assuming we're talking about things like endometriosis and ovarian cysts, which hormonal birth control helps to curb, it's not necessarily the case that there will be an insurance out for women who need to take contraception for non-contraceptive purposes. Besides, your employer might object to that too, unless you're celibate — and should you really have to detail your medical conditions and sex life to your boss?

10. Insurance is only for medical emergencies, not maintenance.

There are catastrophic insurance plans you can purchase that cover only major medical emergencies, but typically, insurance does cover many kinds of maintenance medicine and preventative care. It would be absurd (not to mention financially irresponsible) if insurance only covered, say, ER visits for diabetic shock but didn't offset the cost of insulin or if it paid for emergency care for a near-fatal asthma attack but not inhalers.

"One of the best parts of the ACA is that it in fact requires that a range of preventive health care services be covered without cost-sharing requirements," Gonen said. "The medical and public health communities have long touted the benefits of preventive health care, not only in keeping people healthy but in reducing medical costs because illnesses are prevented."

"Actually a lot of insurance plans do cover those medications, just as they should cover birth control," Gonen said. The insurance offered by Hobby Lobby covers both vasectomies and Viagra.

12. If you were a truly independent woman, you'd pay for your own contraception and not expect it from your boss or the government.

"I do pay for my own birth control through my hard work and my premium dollars," Abolfazli said. "Health insurance is part of your compensation package, and health insurance is supposed to cover your health care needs."

And no one suggests that men aren't sufficiently independent if their health insurance covers Viagra or cholesterol medicine. It's not "dependent" to expect that insurance you pay premiums for and that comes as part of your labor will cover your health care needs; it's reasonable and responsible.

13. If you don't like it, find another job.

If only it were so easy to find full-time gainful employment with benefits. The unemployment rate currently sits at6.3 percent, but that doesn't count the people who are underemployed or just so discouraged they stopped looking for work. A more comprehensive evaluation of unemployed and underemployed Americans puts the rate at almost 13 percent. "Just get a different job" is a tall order for many Americans.

And besides, why should women be forced accept discrimination by seeking a different employer?

A Part of Hearst Digital Media
Cosmopolitan participates in various affiliate marketing programs, which means we may get paid commissions on editorially chosen products purchased through our links to retailer sites.